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Employment Application

PLEASE READ CAREFULLYNote: Fields marked with a * require an answer. Please use "N/A" for "not applicable" if necessary. Applicants may be required to complete and sign a paper application for employment upon interview.

Attach Resume:

(pdf, doc, docx)

*Email:

Applying for:

Applicant Information

*First Name:

*Last Name:

MI:

*Address:

Apartment/Unit #

*City

*State

*Zip

*Phone:

Referred By:

Date Available:

Pay Rate Expected:

U.S. Citizen:

Yes
No

*Have you ever worked for this company?:

Yes

No

If yes, when?:

------ To ------

*Have you ever been convicted of a felony?(By company policy some misdemeanors may bar employment):

Yes

No

If yes, explain briefly:

What area would you like to work in?

Education

High School:

Address:

Graduate:

Yes
No

Degree:

College:

Address:

Graduate:

Yes
No

Degree:

Other:

Address:

Graduate:

Yes
No

Degree:

References

Please list two references not related to you, whom you have known at least one year.

Military Service

Start Date:(mm/dd/yyyy)

End Date:(mm/dd/yyyy)

Branch:

Rank at Discharge:

Type of Discharge:

If other than honorable, explain:

Applicant's Statement

Notification and Agreement

I hereby affirm that all information in this application is true and accurate to the best of my knowledge. I understand that the college
can obtain criminal history record information on applicants for employment. Pursuant to the requirements of the Fair Credit
Reporting Act, notice is given that a consumer report+ may be made in connection with your application for employment. I understand
that any misrepresentation or falsification of this record or failure to disclose conviction for a felony or for any offense involving moral
turpitude will be considered cause for dismissal.

If you are denied employment, either wholly or partly, because of information contained in a consumer report, a disclosure will be
made to you of the name and address of the consumer-reporting agency making such report.

Signature below verifies you have read the above notice and understand what it means.